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Gründe für die Nichtteilnahme an einer Patientenbefragung im Kontext der prähospitalen Notfallversorgung durch Gemeindenotfallsanitäter - eine retrospektive Beobachtungsstudie [社区急救护理人员在院前急救医疗护理中不参与患者调查的原因--一项回顾性观察研究]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.03.007
Insa Seeger , Andrea Diana Klausen , Ulf Günther , Jonas Bienzeisler , Helge Schnack , Johanna Sophie Lubasch

Background

In order to evaluate whether the new rescue means “community emergency paramedics” (Gemeindenotfallsanitäter [G-NFS]) relieves the emergency medical service (EMS) in the care of low-priority emergencies, the perspective of general practitioners and patients was also surveyed in a written questionnaire as part of an innovation fund project. Recruitment for participation in the study proved to be difficult. The aim of this study is to evaluate why the G-NFS decided against providing information on study participation and what measures would be necessary to include more emergency patients in surveys in the future.

Methods

Retrospective analysis of the assignment protocols from April 1, 2021 to June 30, 2022. In addition to patient characteristics, data on treatments, interventions and recommendations to patients as well as reasons for non-participation in the patient survey were collected.

Results

5,395 G-NFS protocols that contained information on non-participation were included in the analysis. The average age of the patients was 62.4 years (SD 22.7), and 50.2 % were female. 57.4 % of the cases were categorised as non-urgent, and 35.2 % of the cases required an additional ambulance to be alerted. 404 (7.5 %) patients used the EMS more than once, 1,120 (20.8 %) did not have sufficient language skills, 1,012 (18.8 %) patients declined study participation, and 2,975 (55.1 %) patients were not able to participate according to the G-NFS assessment. Dementia/neurocognitive impairment (35 %), acute/emergency situation (26.5 %), mental health impairment (10.3 %), and substance abuse (6.5 %) were given as reasons for non-participation from the G-NFS perspective.

Discussion

The results show that more than half of the patients were unable to take part in a written survey for various reasons, even though there was no need for urgent care. This could be due to a high demand for care and the complex consent procedure. In addition, further resources are required to provide needs-based care for these patients in order to relieve the burden on emergency medical care. Over half of the patients were unable to take part in a written survey for various reasons. Further research is needed to determine what consent procedures are appropriate to facilitate patients’ study participation.

背景:为了评估新的救援手段 "社区急救辅助人员"(Gemeindenotfallsanitäter [G-NFS])是否减轻了紧急医疗服务(EMS)对低优先级紧急情况的处理,作为创新基金项目的一部分,我们还通过书面问卷调查了全科医生和患者的观点。事实证明,这项研究很难招募到参与人员。本研究旨在评估 G-NFS 为何决定不提供参与研究的信息,以及今后需要采取哪些措施才能让更多急诊患者参与调查:方法:对 2021 年 4 月 1 日至 2022 年 6 月 30 日的分配方案进行回顾性分析。除患者特征外,还收集了患者的治疗、干预和建议数据以及未参与患者调查的原因:结果:5395 份包含未参与信息的 G-NFS 方案被纳入分析。患者的平均年龄为 62.4 岁(SD 22.7),50.2% 为女性。57.4%的病例被归类为非急症,35.2%的病例需要额外的救护车报警。404名(7.5%)患者不止一次使用急救服务,1120名(20.8%)患者语言能力不足,1012名(18.8%)患者拒绝参与研究,2975名(55.1%)患者无法根据G-NFS评估参与研究。从 G-NFS 的角度来看,痴呆/神经认知障碍(35%)、急性/紧急状况(26.5%)、精神健康受损(10.3%)和药物滥用(6.5%)是不参与研究的原因:讨论:结果显示,超过半数的患者因各种原因无法参加书面调查,即使他们不需要紧急护理。这可能是由于护理需求高和同意程序复杂所致。此外,还需要更多的资源来为这些患者提供按需护理,以减轻急诊护理的负担。超过一半的患者由于各种原因无法参加书面调查。我们还需要进一步研究,以确定什么样的同意程序适合促进患者参与研究。
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引用次数: 0
Latente Sicherheitsmängel in einer pädiatrischen Notaufnahme: Testung eines neuen Schockraumkonzepts mithilfe von In-situ-Simulation [儿科急诊室潜在的安全威胁:利用现场模拟测试新的创伤室概念]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.03.005
Anja Große Lordemann , Dirk Sommerfeldt , Lukas Mileder

Introduction

Structured emergency room concepts have been shown to contribute to patient safety. Until now there has been no uniform emergency room concept for critically ill and seriously injured children and adolescents in the emergency room at the Altona Children's Hospital in Hamburg. This concept has been newly developed in interdisciplinary cooperation and includes the use of new clinical premises as well as new responsibilities and team compositions. The introduction of new processes and rooms for handling emergencies is associated with a risk of overlooking latent safety deficiencies or detecting them only after the process has been implemented. This may have a direct impact on patient safety. Before moving to new clinical premises, in situ simulation can be helpful to identify and to resolve latent safety threats in advance. Therefore, this method was chosen to test the newly created emergency room concept in the future emergency room at the Altona Children's Hospital.

Methods

Two in situ simulations were carried out in the future real emergency room. Latent safety threats detected by the observation team and the participants (medical and nursing staff of the Altona Children's Hospital from the departments of pediatric surgery, traumatology, orthopedics, pediatrics, anesthesia, intensive care medicine, radiology, emergency medicine) were collected using free text notes after the simulations and evaluated retrospectively. In order to better deal with these latent safety threats, the observations were classified into different categories: working environment (e. g., lack of equipment, unfavorable positioning of material), process (e. g., lack of defined responsibilities in the team) and other safety threats that did not fall into one of the two categories defined.

Results

A total of 51 latent safety threats were identified during the two in situ simulations. Of these, 22 (43.1 %) were assigned to the “working environment” category, 20 (39.2 %) to the “process” category and 9 (17.7 %) to the “other safety threats” category.

Of the latent safety threats identified, 46 (90.2 %) could be resolved before the emergency room was put into operation. For the non-recoverable safety threats, safety concepts were developed in order to further minimize the risk of patient hazard.

Discussion

With the help of this study, it could be shown that the implementation of in situ simulation before the commissioning of new clinical premises and the introduction of new processes can contribute to the detection of latent safety threats in an interdisciplinary German pediatric emergency department.

导言:结构化急诊室概念已被证明有助于患者安全。迄今为止,汉堡阿尔托纳儿童医院的急诊室还没有针对重病重伤儿童和青少年的统一急诊室理念。这一概念是在跨学科合作的基础上新开发的,包括使用新的临床场所以及新的职责和团队组成。在引入新的急诊处理流程和房间时,有可能会忽略潜在的安全缺陷,或在流程实施后才发现这些缺陷。这可能会直接影响病人的安全。在搬迁到新的临床场所之前,现场模拟有助于提前发现和解决潜在的安全威胁。因此,我们选择了这种方法来测试阿尔托纳儿童医院未来急诊室新创建的急诊室概念:方法:在未来的真实急诊室中进行了两次现场模拟。观察小组和参与者(来自阿尔托纳儿童医院小儿外科、创伤科、骨科、儿科、麻醉科、重症监护医学科、放射科和急诊科的医护人员)在模拟后使用自由文本记录收集了发现的潜在安全威胁,并进行了回顾性评估。为了更好地处理这些潜在的安全威胁,观察结果被分为不同的类别:工作环境(如缺乏设备、材料摆放位置不利)、流程(如团队中缺乏明确的职责)以及不属于上述两个类别的其他安全威胁:在两次现场模拟中,共发现了 51 个潜在的安全威胁。其中,22 个(43.1%)属于 "工作环境 "类别,20 个(39.2%)属于 "流程 "类别,9 个(17.7%)属于 "其他安全威胁 "类别。在已发现的潜在安全威胁中,有 46 个(90.2%)可以在急诊室投入使用前得到解决。对于无法解决的安全威胁,则提出了安全概念,以进一步降低对患者造成危害的风险:这项研究表明,在新临床设施投入使用和引入新流程之前进行现场模拟,有助于发现德国跨学科儿科急诊室潜在的安全威胁。
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引用次数: 0
Bürgerzentrierte Gesundheitsversorgung in Deutschland – eine Analyse von ExpertInneninterviews [德国以公民为中心的医疗保健:专家访谈分析]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.03.010
Eva Steinfeld , Katharina Schneegans , Carina Benstoem , Michaela Hesse , Sandra Dohmen

Background

Citizens can represent a relevant key resource in health care, for example by actively practicing preventive health care and managing their own health care needs. In Germany, the role of citizens in the health care system has not yet been defined. Therefore, the aim of this study is, as a first step, to determine what is meant by “citizen-centred healthcare”, since there is, as yet, no clear definition.

Methods

Between September and November 2022, semi-structured expert interviews were conducted with representatives from the fields of politics and self-administration and service providers and, with their consent, recorded and transcribed. A category system was developed inductively and deductively based on Mayring's content analysis. Using this, two members of the project team coded the interviews independently of each other using the QCAmap software. After a replication check of the deviations, the content could then be analyzed.

Results

A total of n = 10 interviews were conducted (n = 3 service providers, n = 2 self-administration, n = 5 politicians). The analysis revealed two different understandings of citizen-centred healthcare. Some of the experts understand citizen-centred healthcare as care that is provided close to home and easily accessible for citizens. The others interpret the term as care where citizens take on an active role. All interviewees saw the lack of health literacy among citizens as a key challenge. The social imbalance, which creates an inequality of opportunity in the involvement of citizens, was also mentioned several times. Opportunities were generally understood as the possibility of conserving resources and maintaining health. The analysis shows that there is still a lack of solutions that specifically address these challenges as well as the implementation of citizen-centred health care.

Discussion

The expert interviews demonstrate that there are two fundamentally different understandings of citizen-centred healthcare and how it should be established in Germany. Future research should therefore pursue the goal of developing a definition of “citizen-centred health care” by expert consensus. This can then form the basis for concrete, future goals for action. There was consensus among the experts regarding the problems that need to be considered in this context. Factors such as citizens' lack of health literacy and social imbalance should therefore be given more attention in the future.

背景:公民可以成为医疗保健领域的重要资源,例如,他们可以积极开展预防性医疗保健活动,管理自己的医疗保健需求。在德国,公民在医疗保健系统中的作用尚未得到界定。因此,本研究的目的首先是确定 "以公民为中心的医疗保健 "的含义,因为目前还没有明确的定义:方法:2022 年 9 月至 11 月期间,对来自政治和自我管理领域的代表以及服务提供者进行了半结构化专家访谈,并在征得他们同意后进行了记录和转录。在 Mayring 内容分析法的基础上,以归纳和演绎的方式建立了一个分类系统。在此基础上,项目小组的两名成员使用 QCAmap 软件对访谈进行了独立编码。在对偏差进行重复检查后,便可对内容进行分析:共进行了 n = 10 次访谈(n = 3 次服务提供者访谈,n = 2 次自我管理访谈,n = 5 次政治家访谈)。分析显示,对 "以公民为中心的医疗保健 "有两种不同的理解。一些专家将 "以民为本 "的医疗保健理解为就近提供、方便公民使用的医疗保健。其他专家则将其解释为公民发挥积极作用的医疗保健。所有受访者都认为,公民缺乏保健知识是一个主要挑战。受访者还多次提到社会不平衡问题,这造成了公民参与机会的不平等。机会一般被理解为节约资源和保持健康的可能性。分析表明,在应对这些挑战以及实施以公民为中心的医疗保健方面,仍然缺乏专门的解决 方案:专家访谈表明,对于以公民为中心的医疗保健以及如何在德国建立这种医疗保健,存在着两种截然不同的理解。因此,未来的研究应致力于通过专家共识制定 "以公民为中心的医疗保健 "的定义。这将成为未来具体行动目标的基础。专家们对这方面需要考虑的问题达成了共识。因此,今后应更多地关注公民缺乏保健知识和社会不平衡等因素。
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引用次数: 0
Inhaltliche Weiterentwicklung von Standards zur Erstellung evidenzbasierter Gesundheitsinformationen: Eine Bedarfserhebung und Priorisierung im EbM-Netzwerk [推进为消费者开发循证健康信息的标准:循证医学网络成员的需求和优先事项]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.03.011
Roland Brian Büchter , Martina Albrecht , Michael Grimm , Markus Seelig , Anke Steckelberg , Anne Christin Rahn
<div><h3>Background</h3><p>The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development.</p></div><div><h3>Methods</h3><p>In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively.</p></div><div><h3>Results</h3><p>Among the 41 participants, only 23<!--> <!-->% considered the standards to be sufficient, and only 55<!--> <!-->% found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n<!--> <!-->=<!--> <!-->46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, “presenting benefits and harms” and “content beyond treatments (in particular, diagnostics and prognosis)” were considered to be the most important (n<!--> <!-->=<!--> <!-->36).</p></div><div><h3>Discussion</h3><p>Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability – for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a li
背景:健康信息良好实践指南》、《奥地利健康信息良好实践指南》和《循证健康信息指南》是德语地区开发循证健康信息的既定资源。该项目的目的是了解这些标准在实际应用中遇到的挑战,找出差距和发展需求,并为其进一步发展提供见解:2020 年 12 月,循证医学网络患者信息和参与工作组的成员受邀通过在线调查分享他们在应用德国循证健康信息标准方面的经验和需求,调查以开放式问题为主(第 1 部分:需求评估)。通过定性内容分析对反馈意见进行了分析,并在 2021 年 EbM 大会的研讨会上进行了介绍,目的是具体说明需求评估的反馈意见,并讨论进一步制定标准的想法(第 2 部分:具体说明)。最后,在 2023 年 2 月进行了第二次调查,由工作组成员对确定的主题进行优先排序(第 3 部分:优先排序)。对调查结果进行了描述性分析:在 41 名参与者中,只有 23% 的人认为标准是充分的,只有 55% 的人认为在信息开发中应用标准是容易或相当容易的。需求评估和研讨会(人数=46)有助于确定各个行动领域。在标准的应用方面,确定了以下挑战:缺乏用户导向、内容差距、方法和风险沟通。在格式、内容以及与医疗保健服务的联系方面,发现了标准中的差距。为促进标准的发展,提出了增加内容、利益相关者参与和提高标准可用性的想法。在优先顺序调查中,"介绍益处和危害 "和 "治疗以外的内容(特别是诊断和预后)"被认为是最重要的主题领域(n=36):讨论:德国循证医学网络患者信息和参与工作组成员认为,进一步开发循证健康信息标准的需求很高。除内容开发外,还应考虑整合现有文件和工具,包括其他机构发布的产品。推进标准的成功还取决于提高其适用性--例如通过一个有吸引力的在线平台。由于样本仅包括 EbM 网络患者信息和参与工作组的成员,且回复率有限,因此评估结果受到一定限制:需求评估结果表明,德语地区目前已建立的循证健康信息发展标准和建议是重要的基石,但还需要进一步扩展,以回答更多面向实践的问题。与会者提出的挑战和解决方案有助于进一步制定标准。优先次序的确定可用于确定标准制定的优先次序、指导可能的工作包的顺序以及分配资源。
{"title":"Inhaltliche Weiterentwicklung von Standards zur Erstellung evidenzbasierter Gesundheitsinformationen: Eine Bedarfserhebung und Priorisierung im EbM-Netzwerk","authors":"Roland Brian Büchter ,&nbsp;Martina Albrecht ,&nbsp;Michael Grimm ,&nbsp;Markus Seelig ,&nbsp;Anke Steckelberg ,&nbsp;Anne Christin Rahn","doi":"10.1016/j.zefq.2024.03.011","DOIUrl":"10.1016/j.zefq.2024.03.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;The Good Practice Guidelines for health information, Good Health Information Austria and Guideline Evidence-based Health Information are established resources for developing evidence-based health information in the German-speaking regions. The aim of this project was to capture challenges in applying these standards in practice, identify gaps and development needs and gain insights for their further development.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In December 2020, members of the working group for patient information and involvement of the Network for Evidence-based Medicine were invited to share their experiences and needs in applying German standards for evidence-based health information through an online survey focussing on open questions (part 1: needs assessment). The feedback was analysed using qualitative content analysis and presented in a workshop at the EbM Congress 2021 with the goal of specifying the feedback from the needs assessment and discussing ideas for the further development of the standards (part 2: specification). In the final step, a second survey was conducted in February 2023 to prioritize the identified topics by the working group members (part 3: prioritization). The results were analysed descriptively.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Among the 41 participants, only 23&lt;!--&gt; &lt;!--&gt;% considered the standards to be sufficient, and only 55&lt;!--&gt; &lt;!--&gt;% found their application in the development of information to be easy or rather easy. The needs assessment and workshop (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;46) helped to identify various areas of action. With regard to the application of the standards, the following challenges were identified: lack of user orientation, content gaps, methods and risk communication. Gaps in the standards were identified regarding formats, content, and the connection to healthcare provision. For the advancement of the standards ideas for additional content, stakeholder involvement, and improvement of the usability of the standards were identified. In the prioritization survey, the topic areas, “presenting benefits and harms” and “content beyond treatments (in particular, diagnostics and prognosis)” were considered to be the most important (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;36).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;p&gt;Among members of the working group for patient information and involvement of the German Network for Evidence-based Medicine, a high demand has been identified for the further development of standards for creating evidence-based health information. In addition to content development, the integration of existing documents and tools should also be considered, including products issued by other institutions. The success of advancing the standards also depends on improving their applicability – for example through an attractive online platform. The results are limited by the sample which only included members of the EbM Network's patient information and participation working group and a li","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Pages 42-52"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Akademisiertes Pflegefachpersonal aus Drittstaaten: Professionelles Selbstverständnis vs. berufliche Realität in Deutschland? Eine qualitative Studie am Beispiel migrierter philippinischer Pflegefachpersonen [来自第三国受过学术教育的护士:职业自我概念与在德国的工作生活。以菲律宾移民护士为例的定性研究]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.04.005
Maike Zwergel , Phillip Florian Schmidt , Kerstin Hämel

Background

The recruitment of internationally educated nurses is gaining relevance in Germany in response to the growing shortage of nurses. Differences in nursing qualifications and practices between the country of origin and of destination can irritate the professional self-concept and hinder professional integration.

Purpose

The study objective was to examine the development of the professional scope of action to unfold the professional self-concept of academically qualified nurses in Germany.

Methods

In accordance with the episodic interview, eight guided interviews were conducted with Filipino nurses who had migrated to Germany. Data was analyzed by thematic coding.

Results

The analysis shows two dimensions that impact the professional scope of action: perceived systemic constraints in the transition process and perspectives on professional development. The recruitment and recognition process is associated with high financial and time-related uncertainties and professional devaluation experiences. Migrant nurses experience both a loss of competence and a sense of foreignness in their nursing role in Germany. In order to regain professional scope of action, strategies of continuing education and focusing on more technology-intensive nursing care areas are pursued; only a minority can adapt their self-concept to the circumstances of nursing practice in Germany.

Discussion

The study results demonstrate the importance of paying attention to both the competence profile and the professional self-concept of academically educated nurses in order to offer migrant nurses professional career prospects in Germany. Especially in long-term care, this has proved to be a structural problem.

Conclusion

To provide an attractive destination for international academically qualified nursing professionals in Germany, the ratification of international standards, the provision of transparent and independent information, utilization of existing nursing expertise as well as the establishment of career opportunities are recommended.

背景:为应对日益严重的护士短缺问题,德国开始招聘受过国际教育的护士。目的:本研究的目的是探讨在德国接受过高等教育的护士的专业行动范围的发展情况,以展开其专业自我概念:按照情节访谈法,对移民到德国的菲律宾护士进行了八次有指导的访谈。结果:分析表明,有两个维度影响着移民到德国的菲律宾护士的职业生涯:分析表明了影响专业行动范围的两个维度:过渡过程中感知到的系统限制和对专业发展的看法。招聘和认可过程与经济和时间方面的高度不确定性以及专业贬值经历相关。移民护士在德国的护理工作中既体验到了能力的丧失,也体验到了陌生感。为了重新获得专业行动范围,她们采取了继续教育和专注于技术密集型护理领域的策略;只有少数人能够使其自我概念适应德国的护理实践环境:研究结果表明,要为移民护士提供在德国的职业前景,必须同时关注受过高等教育的护士的能力概况和职业自我概念。特别是在长期护理领域,这已被证明是一个结构性问题:为了在德国为受过高等教育的国际护理专业人员提供一个有吸引力的目的地,建议批准国际标准、提供透明和独立的信息、利用现有的护理专业知识以及创造职业机会。
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引用次数: 0
MMpowerment: Empowering patients with multiple myeloma for shared decision-making by developing an intervention to integrate personal preferences into digital care pathways MMpowerment:通过制定一项干预措施,将个人偏好纳入数字护理路径,增强多发性骨髓瘤患者的能力,使其能够共同决策。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.04.002
Mirjam Garvelink , Atena Mahboubian , Okke de Weerdt , Paul van der Nat

Objective

As part of a quality improvement initiative in the context of value-based health care we aimed to optimize the shared decision-making (SDM) process in the care pathway for Multiple Myeloma as part of a digital care pathway (DCP). For this, more insight was needed in health care professionals’ (HCPs’) perspectives on SDM, and how SDM elements could be addressed in a DCP for MM to facilitate HCPs’ performance of SDM.

Methods

HCPs were interviewed as per the theory of planned behaviour and the model of organizational context and SDM (phase 1). Multidisciplinary development sessions were organized to discuss concepts of the solution with HCPs (phase 2). The solution was evaluated with two patients from the quality improvement team.

Results

In phase 1, ten interviews were held. HCPs’ attitudes and the subjective norm towards SDM were positive, and the intention to perform SDM was high. The clinical environment (physical context, disease characteristics, assumptions about patient characteristics, and workflows) for MM posed challenges on the actual SDM behavior. Education and use of the DCP to create awareness of SDM were seen as possible facilitators for SDM. A prepared and active patient would facilitate the SDM process. In phase 2, three concept solutions were developed before arriving at the final solution. The final solution consisted of three elements to incorporate SDM steps in the DCP: 1) creating patient awareness and activation with two questions about their preferences prior to a consultation, 2) visualisation of preferences centrally in the DCP to trigger HCP to discuss them, 3) monitoring and improving SDM with patient-questionnaires after decision-making. Patients and HCPs were willing to implement it.

Conclusion

HCPs intention to engage in SDM was high, but their actual behaviour was challenged by the clinical environment. A 3-element DCP-based intervention was developed to increase SDM.

Patient or public contribution

Input on the solution was obtained from end-users including two patients and ten healthcare professionals.

目的:作为以价值为基础的医疗质量改进计划的一部分,我们旨在优化多发性骨髓瘤护理路径中的共同决策(SDM)流程,将其作为数字护理路径(DCP)的一部分。为此,我们需要更深入地了解医疗保健专业人员(HCPs)对 SDM 的看法,以及如何在多发性骨髓瘤的 DCP 中处理 SDM 要素,以促进 HCPs 执行 SDM。方法:根据计划行为理论和组织环境与 SDM 模型(第一阶段)对 HCPs 进行了访谈。组织多学科开发会议,与保健医生讨论解决方案的概念(第 2 阶段)。质量改进小组的两名患者对解决方案进行了评估:第一阶段共进行了 10 次访谈。医疗保健人员对 SDM 的态度和主观规范都是积极的,而且执行 SDM 的意愿也很高。MM 的临床环境(物理环境、疾病特征、对患者特征的假设以及工作流程)给实际 SDM 行为带来了挑战。教育和使用 DCP 来建立 SDM 意识被认为是 SDM 的可能促进因素。有准备且积极的患者将促进 SDM 进程。在第二阶段,在得出最终解决方案之前,制定了三个概念解决方案。最终的解决方案包括将 SDM 步骤纳入 DCP 的三个要素:1)在会诊前提出两个关于患者偏好的问题,以提高患者的意识和积极性;2)在 DCP 中集中显示患者的偏好,以触发 HCP 讨论这些偏好;3)在决策后通过患者问卷调查监测和改进 SDM。患者和医疗保健人员都愿意实施:结论:医疗保健人员参与 SDM 的意愿很高,但他们的实际行为受到临床环境的挑战。我们开发了一种基于 DCP 的三要素干预措施,以增加 SDM:患者或公众的贡献:最终用户(包括两名患者和十名医护人员)对解决方案提出了意见。
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引用次数: 0
Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations Affiliierten Institute und Fachgesellschaften / 关联机构列表
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/S1865-9217(24)00109-0
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引用次数: 0
Leserbrief zu „Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness” (ZEFQ 186 (2024) 86–91) von W. Külper-Schiek et al. Leserbrief zu "Needs and feasibility of living systematic reviews (LSRs):关于 COVID-19 疫苗有效性的活系统综述经验"(ZEFQ 186 (2024) 86-91) von W. Külper-Schiek et al.
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.05.002
Hinpetch Daungsupawong , Viroj Wiwanitkit
{"title":"Leserbrief zu „Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness” (ZEFQ 186 (2024) 86–91) von W. Külper-Schiek et al.","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.zefq.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.zefq.2024.05.002","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"187 ","pages":"Page 100"},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antwort auf Leserbrief zu „Needs and feasibility of living systematic reviews (LSRs): Experience from LSRs on COVID-19 vaccine effectiveness” (ZEFQ 186 (2024) 86–91) von W. Külper-Schiek et al. von Hinpetch Daungsupawong (ZEFQ 187 (2024) 100) 对 "活系统综述(LSR)的需求和可行性:W. Külper-Schiek 等人 (ZEFQ 186 (2024) 86-91) von Hinpetch Daungsupawong (ZEFQ 187 (2024) 100)
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.05.001
Vanessa Piechotta, Wiebe Külper-Schiek
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引用次数: 0
Situation des wissenschaftlichen Nachwuchses in der Versorgungsforschung – eine Survey-Studie [卫生服务研究领域早期职业研究人员的状况:调查研究]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-06-01 DOI: 10.1016/j.zefq.2024.05.006
Anna Levke Brütt , Anne Fahsold , Juliane Köberlein-Neu , Rebecca Palm , Nadine Janis Pohontsch , Lisa Tönnis

Background

Early career researchers in health services research work in an interdisciplinary field of research. So far, information on early career researchers in health services research has only been available from surveys of individual disciplines, which do not adequately reflect the concerns in the field of health services research. Therefore, a working group of the German Network for Health Services Research (DNVF) conducted a first survey. The following research questions can be answered on the basis of the data obtained: (1) Which socio-demographic aspects characterize early career researchers in health services research? (2) What is the professional biographical background of early career researchers in health services research? (3) What are the research fields of early career researchers? (4) What are the career perspectives of early career researchers?

Method

The survey among early career researchers was conducted as an online survey in January/February 2019. The study was addressed to individuals currently working as early career researchers in health services research in Germany. The online survey was conducted using a standardized questionnaire. Participants were recruited through the DNVF access points and by snowball sampling.

Results

336 early career researcher aged between 23 and 57 participated in the online survey study, 102 of whom held a doctorate. The majority were employed as scientific staff (58 %) and were in temporary employment (75 %); 69 % of them were emplyed at a university, followed by health care institutions (17 %) and non-university research institutions (16 %). About one-third of the respondents (36 %) completed a vocational training prior to their studies. Of the participants, 50 % said they were strongly or very strongly aspiring to a professional career in academia, 43 % at a non-university research institution, and 30 % at a university of applied sciences.

Discussion

The results of the online survey show the heterogeneity in terms of age and professional biography of early career researchers in health services research. Few researchers have permanent positions. However, the majority of respondents would like to have a professional future at a university, a research institute or a university of applied sciences. Further studies should be conducted to determine (possible) career paths taken by young scientists in health services research.

Conclusion

There is still scope for improvement in the promotion of early career researchers.

背景:医疗服务研究领域的早期职业研究人员从事的是跨学科研究工作。迄今为止,有关医疗服务研究领域早期职业研究人员的信息只能从个别学科的调查中获得,而这些调查并不能充分反映医疗服务研究领域所关注的问题。因此,德国医疗服务研究网络 (DNVF) 的一个工作组进行了首次调查。根据所获得的数据,可以回答以下研究问题:(1) 医疗服务研究领域的早期职业研究人员具有哪些社会人口特征?(2) 从事保健服务研究的早期职业研究人员的专业背景如何?(3) 早期职业研究人员的研究领域是什么?(4) 早期职业研究人员的职业前景如何?对早期职业研究人员的调查于 2019 年 1 月/2 月以在线调查的形式进行。研究对象为目前在德国从事医疗服务研究的早期职业研究人员。在线调查使用标准化问卷进行。参与者通过 DNVF 访问点和滚雪球式抽样进行招募:336名年龄在23至57岁之间的早期职业研究人员参与了在线调查研究,其中102人拥有博士学位。大多数受访者是科研人员(58%)和临时工(75%);69%的受访者在大学工作,其次是医疗机构(17%)和非大学研究机构(16%)。约有三分之一的受访者(36%)在学习之前完成了职业培训。50%的受访者表示,他们强烈或非常强烈地希望在学术界从事专业工作,43%的受访者希望在非大学研究机构工作,30%的受访者希望在应用科学大学工作:讨论:在线调查的结果显示,医疗服务研究领域的早期职业研究人员在年龄和职业履历方面存在差异。很少有研究人员拥有长期职位。不过,大多数受访者都希望将来能在大学、研究所或应用科学大学工作。应开展进一步研究,以确定卫生服务研究领域的青年科学家(可能的)职业道路:结论:在提升早期职业研究人员方面仍有改进的余地。
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引用次数: 0
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Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen
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